Postoperative hyperglycemia in patients undergoing cytoreductive surgery and HIPEC: A cohort study

Hyperglycemia following elective or emergency surgery is generally associated with an increased risk of complications. The impact of hyperglycemia following surgery for peritoneal surface malignancy remains unclear.

Records of patients undergoing cytoreduction and HIPEC for peritoneal surface malignancy were reviewed at two institutions. Postoperative hyperglycemia was defined as serum glucose >140 mg/dl at the first measurement after surgery. Lengths of stay and 30-day complication rates were recorded.

There were 115 total patients included, 65 from Institution A (A) and 50 from Institution B (B). Perioperative steroids were given to 55% (A) and 100% (B) of patients, with postoperative hyperglycemia present in 39% and 86% of patients respectively. Complication rates were not significantly different in patients with hyperglycemia versus patients who were normoglycemic at each site [56% vs. 53%, p = 0.8 at (A); 47% vs. 43%, p = 1.0 at (B)]. Infection rates were also similar between groups [16% vs. 13%, p = 0.72 at (A); 14% vs. 29%, p = 0.31 at (B)].

Rates of hyperglycemia in patients undergoing cytoreduction and HIPEC are high. This likely represents a stress response but does not seem to have the same adverse impact as seen in other abdominal surgical patient populations.